It may seem weird in a era when childhood obesity is a major concern that many parents worry that their children are underweight.
Kids who are underweight present parents with a particular challenge. How do you encourage weight gain without encouraging weight gain? You know what I mean. No one wants to solve one problem only to produce another problem.
Here’s my advice:
First, make sure your child doesn’t have a medical problem. Then, rule out oral-motor skill difficulties. If your child has trouble chewing or gags frequently you might want to see a speech therapist who is also a feeding specialist.
If there is nothing medical going on, do the unthinkable: Serve less food.
No, I’m not nuts. Sometimes Less is More.
What’s the most common advice for resolving the underweight problem? Feed your kids high calorie foods.
- Add oil, butter, and cream to foods.
- Give your children ice cream. (One pediatrician told a client to give her daughter ice cream whenever she wanted it. BTW, this tactic didn’t solve the weight problem but it did produce a feeding problem. What child wants to eat real food when she can have ice cream?)
- Provide snacks like avocado and banana which are high in calories.
Here’s where I part ways with all the other experts.
It’s not that I’m against feeding kids high calorie foods. This strategy can work. The tactic goes awry, however, when parents feel pressure to get their children to eat more food than their kids actually want to eat.
Parents of underweight children often “bombard” their kids with food. And by bombard, I simply mean presenting more food, or more eating opportunities, or more filling foods more frequently. This “kills” underweight kids’ appetites.
Here’s the thing. You know how big portions can make many people overeat? Well, big portions can make underweight kids eat less. Yes, instead of overriding the fullness signal, under-eaters override their hunger signals.
So the question becomes: What’s a big portion? Only your child can answer that.
And the only problem with that is that most children can’t articulate the idea that you’re serving them too much food, or you’re serving food too frequently, or…they’re still full because you served them a bunch of high calorie food.
The answer is to serve less food. Let your child come back for seconds. Use the Eating Zones to give your child a scheduled break from eating and from even having to think about food.
Many underweight children are simply under-eaters who are easily overwhelmed by too much food or too much pressure to eat. These children need time and space to feel their hunger signals. Serving smaller portions, sometimes ridiculously smaller portions, eliminates the pressure. This in turn lets kids feel how hungry they really are. The end result? They actually eat more.
Pediatricians, understandably, become concerned when children are in the bottom part of the weight distribution. It’s often hard to know if an underweight child is simply slight or if low weight signifies a problem.
The things to look for:
- Your child’s weight percentage on the growth chart declines. In other words, if a child falls off his own growth curve.
- Your child doesn’t seem to outgrow her clothes as often as her peers.
- You can see your child’s ribs.
None of these, by the way, is a definitive sign that something is wrong. I used to worry about about my own daughter’s weight — she fell of her weight curve once (and then stayed on the new curve) and I could see her ribs, but she was just fine.
~Changing the conversation from nutrition to habits.~